Rash

Pathological elements are divided into primary and secondary.

Primary elements are rashes that appear on unchanged skin, can be cavity (having a cavity filled with serous, bloody or purulent contents) and cavityless.

Secondary elements - resulting from changes in the primary elements of skin rashes.

Primary morphological elements of a rash

• Tubercle ( lat. Tuberculum ) ^[2] - an element, without a cavity, lies deep in the dermis, sizes from 0.5 to 1 cm in diameter, the color and relief of the skin above the element are changed, leaving a scar or scar atrophy. May change until ulcer forms.
• Blister ( lat. Urtica ) ^[3] an element without a cavity, round or irregular in shape, pink in color, sometimes with a whitish tint in the center, occurs due to edema of the papillary dermis, exists from several minutes to several hours. Accompanied by itching. It disappears without a trace.
• The papule , or nodule ( lat. Papula ) ^{[4] is a} non-cavity element with a discolored skin that resolves without a trace. The depth of occurrence of epidermal , dermal and epidermodermal . Nodules can be inflammatory and non-inflammatory. Depending on the size, the nodules are miliary 1-3 mm in diameter, lenticular 0.5-0.7 cm in diameter and numular 1-3 cm in diameter.
• Bubble ( lat. Vesicula ) ^[5] - an element having a bottom, a tire and a cavity, up to 0.5 cm in diameter, with serous or serous-hemorrhagic contents. They can be single-chamber or multi-chamber. Bubbles can be located intraepidermally (in the epidermis) or subepidermally (under the epidermis). At autopsy, erosion is formed.
• Bubble ( lat. Bulla ) ^[6] - an element consisting of a bottom, a tire and a cavity, more than 0.5 cm in diameter, with serous or hemorrhagic contents. It can be located subepidermally and intraepidermally. After opening, erosion is formed.
• Pustule or abscess ( lat. Pustula ) ^[7] - an element with purulent contents. The location in the skin distinguishes between superficial and deep , follicular and non-follicular .
  • Superficial non-follicular pustules - conflicts - have a tire, bottom and cavity with unclear contents, and redness around. They are located in the epidermis and look like bubbles. With regression, crusts form, after which temporary depigmentation or hyperpigmentation remains.
  • Deep non-follicular pustules - ectims - form ulcers with a purulent bottom, leaving scars behind themselves.
  • Superficial follicular pustules capture 2/3 of the follicle , are located in the epidermis or papillary dermis, have a conical shape, size - 1-5 mm, with hair in the center. In place of their secondary elements does not remain.
  • Deep follicular pustules capture the entire hair follicle and are located throughout the dermis. In the center, one ( boil ) or several ( carbuncle ) necrotic rods is formed. A scar forms in their place.
• Spot ( lat. Macula ) ^[8] Local change in skin color of the cover. The spots are vascular - inflammatory or non-inflammatory, pigmented and artificial (tattoo). ^[9]
• A node ( lat. Nodus ) ^[9] is an element without a cavity with infiltration , lies deep in the dermis or hypodermis and has large dimensions (from 2 to 10 cm or more in diameter). Nodes can be inflammatory and non-inflammatory. A scar is formed at the site of the node.
• Roseola ( lat. roseola ) - a speck of pale pink, red in size from 1 to 5 mm, irregular or rounded, the edges are clear or blurry, does not protrude above the skin level, disappears when the skin is pressed and stretched. Roseola is found in many infectious diseases, especially typical of typhoid fever.
• Hemorrhage ( lat. Haemorrhagia ) - hemorrhage in the skin as a result of destruction of blood vessels of the skin. It has the appearance of dots or spots of various sizes and shapes, does not disappear when the skin is stretched.

Secondary morphological elements of the rash

• Skin atrophy ( lat.atrophia )
• Vegetation ( lat. Vegetatio ) - the growth of the epithelium and papillary dermis. ^[10]
• Hyperpigmentation ( lat. Hyperpigmentatio ) - a change in the color of the skin (usually darkening, discoloration) associated with an increase in the amount of melanin or the accumulation of hemosiderin in place of the disappeared primary elements.
• Dyschromia of the skin ( lat. Dyschromia cutis ) ^[11]
• Depigmentation ( lat. Depigmentatio ) - temporary or permanent persistent discoloration of skin areas after the disappearance of some primary rashes, resulting from a decrease in melanin level.
• Lichenification ( lat. Lichenificatio ) is a hotbed of an enhanced skin pattern that is thickened, dry, pigmented or has a pinkish tint. Rhomboid nodules surrounded by deep linear grooves are visible. Sometimes the focus is covered with abrasions, hemorrhagic small crusts formed during scratching. Lichenification occurs in chronic dermatoses, accompanied by severe itching, more often with eczema and neurodermatitis. Favorite localization is the neck, popliteal and elbow bends, inguinal folds. ^[12]
• Tripe ( lat. Cicatrix ) ^[13]
• Abrasion or excoriation ( lat. Excoriatio ) ^[14] is a superficial skin defect resulting from scratches, scratches, and other injuries. They are more prone to infection. ^[12]
• The scab is formed when the contents of the vesicles, pustules, as well as serous, purulent or bloody discharge of erosion and ulcers dry. Its color is different and depends on the nature of the exudate that formed them. ^[12]
• Cracks ( lat. Fissura ) and tears ( lat. Rhagades ) ^[15] arise due to a violation of the integrity of the skin due to loss of its elasticity. Caused by inflammation or overstretching of the skin. Cracks are usually linear in shape. They are located within both the stratum corneum, and the entire epidermis and surface layers of the dermis. Superficial cracks after their healing leave no traces, and after deep cracks linear scars remain. ^[12]
• Scales ( lat. Squama ) ^[16] are loose, glued together, glued horn plates. In shape and size, they can be pityrious, when the skin is as if sprinkled with flour, and lamellar. The color of the scales is diverse - white, gray, brown, yellow. ^[12]
• Erosion ( lat. Erosio ) ^[14]
• Ulcer ( lat. Ulcus ) ^[17]
• Plaque (lat. Tubula ) is a flattened formation on the skin with a diameter of more than 5 mm, elevated above the skin level. Plaques form when papules merge and can have clear boundaries (for example, with psoriasis), or merge with the surrounding skin (for example, with various dermatitis).

Diagnostics is carried out comprehensively. An anamnesis is being collected, it turns out whether such episodes were earlier, whether any of the relatives suffered from similar diseases, which, in the patient's opinion, caused the rash.

An important role is played by the subjective complaints of the patient, the presence of itching, pain, discomfort, their intensity and frequency. For an adequate assessment of the rash, the patient's skin is examined in direct and transmitted light. ^[eighteen]

The prognosis for life and working capacity is conditionally favorable, despite subjective discomfort, objectively there is a minimal threat to life, in some cases, if the process is severe, work capacity is reduced. In cases where the rash syndrome in the disease is not leading, the prognosis is determined by the presence and severity of other clinical syndromes.

Allergic rash, or urticaria

• Rashes // Brockhaus and Efron Encyclopedic Dictionary : in 86 volumes (82 volumes and 4 additional). - SPb. , 1890-1907.
• Skin and sexually transmitted diseases. Manual for Doctors / Ed. Yu. K. Skripkin. - M .: Medicine, 2002. - T. 1. - 576 p. - ISBN 5-225-02856-x .
• Vladimirov V.V., Zudin B.I. Skin and sexually transmitted diseases. Atlas. - M .: Medicine, 1980. - 288 p. - 30,000 copies.